Thanks to the efforts of Rep. Bruce Braley, D-Iowa, Marshalltown Medical & Surgical Center will be getting $275,000 in back Medicare reimbursements.
The influx of money comes by way of a provision of the Affordable Care Act known as the lowest quartile provision, which Braley lobbied for. The provision injects money into hospitals in the lowest 25 percent of counties receiving Medicare reimbursements.
Jeff Geirtz, communications director for Braley, said the Congressman is trying to help affect a change in the way Medicare reimburses hospitals.
Unfortunately, he said, the system tends to reward quantity over quality by assuming that costs in rural areas are substantially lower. Since reimbursements are determined largely by geography, hospitals in the middle of the spectrum are often thrown under the bus because they are looked at the same as larger hospitals who have a wealth of resources.
"A doctor in Marshalltown that performed an X-ray on a patient compared to a doctor in New York are paid very differently," Geirtz said.
Bob Downey, CFO for MMSC, said the hospital will also get another $512,000 because of a rural budget neutrality appeal, which is a one-time allocation due to government errors in applying the formula by which Medicare allocations are determined.
He said he is unsurprised by these allocations.
"It's not an unusual thing because Iowa is pretty efficient from one end of the state to the other," he said. "It's good that the system works that well."
Iowa hospitals not only have a higher percent of patients dependent on Medicare, said Scott McIntyre, director of communications for the Iowa Hospital Association. Not only that, but they also continually provide a higher standard of care than hospitals in other states whose Medicare reimbursements dwarf Iowa hospitals.
He said the Dartmouth Atlas of Healthcare is the measuring stick by which healthcare quality is measured.
"What they have found over the years is that more care is not necessarily better care," he said.
Braley will continue to push for provisions to reform Medicare assessments to solve this issue, Geirtz said.